NPI 1245013770

Magnolia Behavioral Health, PLLC

Organisation Prevention Professional Fuquay Varina, NC

Practice location

Address: 602 E Academy St STE 205, Fuquay Varina, NC 27526-2382
Phone: (919) 635-6202
Fax: (919) 289-1713

Authorised official

Name: Jacqueline Wenzel
Title: Ceo/Owner
Phone: (919) 961-1948

Registered specialties (4)

Prevention Professional Primary

Other Service Providers Taxonomy 405300000X

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Registered Nurse

Nursing Service Providers Taxonomy 163W00000X

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Specialist

Other Service Providers Taxonomy 174400000X

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Psychiatric/Mental Health Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363LP0808X

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Registry record

NPI: 1245013770
Entity type: Organization
NPI issued: 17 Aug 2023
Record last updated: 8 Mar 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.